Health inspection·March 7, 2025

42 CFR § 483.90(i)(4), 22 CCR § 72637 (a)(f), 72521 (a)(b), 72345 (a), 76681 F925 42 CFR §483.90(i)(4) Maintain an effective pest control program so that the facility is free of pests and rodents. 22 CCR § 72637. General Maintenance. (a) The facility, including the grounds, shall be maintained in a clean and sanitary condition and in good repair at all times to ensure safety and well-being of patients, staff and visitors. (f) The facility shall be maintained free from vermin and rodents through operation of a pest control program. The pest control program shall be conducted in the main patient buildings, all outbuildings on the property and all grounds. 22 CCR § 72521. Administrative Policies and Procedures. (a) Written administrative, management and personnel policies shall be established and implemented to govern the administration and management of the facility. (b) All policies and procedures required by these regulations shall be in writing and shall be carried out as written. They shall be made available upon request to patients or their agents and to employees and the public. Policies and procedures shall be reviewed at least annually, revised as needed and approved in writing by the governing body or licensee. 22 CCR § 72345. Dietetic–Sanitation. (a) All kitchens and kitchen areas shall be kept clean, free from litter and rubbish and protected from rodents, roaches, flies and other insects. 22 CCR § 76681. Pest Control Program. The facility shall be maintained free from insects and rodents through operation of a pest control program. The pest control program shall include main client buildings, all out buildings on the property and all adjacent grounds. On 2/11/2025, the California Department of Public Health (CDPH) made an unannounced visit to the facility to investigate a complaint regarding an allegation of pest in the kitchen. The facility failed to have an effective pest control program, to prevent cockroaches in the kitchen for a facility licensed for a 59-bed count. As a result, live roaches were found in the facility’s kitchen. This deficient practice had the potential to expose 38 residents currently residing in the facility to foodborne illness. During a concurrent observation and interview on 2/11/25 at 1:15 p.m. while in the kitchen with the head chef (HC)the kitchen exhaust hood was observed with grease and dirt build up on the overhead fire sprinklers. The HC stated he doesn't know the last time the kitchen had a deep cleaning for the floors and all areas of the kitchen. The HC stated the kitchen crew does daily sweeping and mopping two times (once during the day and once in the evening after dinner). During an observation on 2/11/25 at 1:40 p.m. while in the kitchen near the dishwashing area, four gray colored plastic compartment cup racks were stacked upon each other on the floor under the stainless-steel table. When the trays were pulled aside from underneath the table, two cockroaches were observed crawling on the lower wall. The wall, pipes, baseboard and tile floor all had white and brown residue build up; the wall had black, brown and white residue/stains and the grout in the tile floor was black in color. During an interview on 2/11/25 at 2:10 p.m. with the Infection Preventionist (IP), the IP stated there were no reported instances of cockroaches in the resident's room or in the resident's food. The IP stated she does a walk-through in the kitchen once a month. The IP stated she was aware that the kitchen was closed for 48 hours due to cockroaches found in the kitchen. The IP stated no food from the kitchen will be served to the residents after lunch time on 2/11/25, and the facility's administration is working on who will provide food to the residents for dinner on 2/11/25. During a concurrent interview on 2/11/25 at 2:22 p.m. with the Director of Environmental Services (DES) and the Housekeeping Supervisor (HKS), the DES stated a professional deep cleaning is performed by a contracted vendor twice a year in the kitchen. The DES stated the last cleaning was completed on 8/12/24. The HKS stated the housekeeping department does not clean the kitchen area; the kitchen/dinning staff clean the kitchen daily. The HKS stated housekeeping cleans the common areas used by the residents: bathrooms, showers, hallways, and resident's rooms. The HKS stated she completes a work order or sends a notification e-mail to the Maintenance Department for any facility repair needed. The DES stated he will be coordinating the vendor repair work in the kitchen to ensure entry points for any pests are sealed. During an interview on 2/11/25 at 3:46 p.m. with the Administrator (ADMIN), the ADMIN stated the facility does not have a pest control policy. A review of the facility's vendor receipts for pest control services, the Summary of Service (SOS) dated 2/4/25, indicated, "Kitchen area, recommendation: debris collecting under (food prep tables). Please remove debris to prevent unsanitary conditions and attraction by pests. Severity = High; Status: Pending; Date: 9/13/24." The SOS further indicated, "Kitchen area, recommendation: pipes extending through wall allowing pest access. Please fill in gaps between pipes and wall to prevent pest entry. Severity = High; Status: Pending; Date: 9/13/24." A review of the facility's policy and procedure (P&P) titled, "Cleaning Protocol," dated, January 2017, the P&P indicated, "Policy: Housekeeping services will be routinely provided to provide a clean environment which prevents the spread of infection." The P&P did not indicate cleaning of the kitchen area. The P&P indicated the areas cleaned by housekeeping are resident's room (daily and terminal cleaning on discharge), bathroom, nursing stations, central bath/shower rooms, physical therapy room, office areas, public restrooms, storage rooms, and hallway areas." A review of the facility's policy and procedure (P&P) titled, " Infection Prevention & Control Program," revised, January 2024, the P&P indicated, "Overview: Each skilled nursing (SNF) observes its adopted and implemented Infection Prevention and Control Program (IPCP) with standard and transmission-based precautions to be followed to provide a safe, sanitary and comfortable environment that helps prevent the development, transmission and spread of communicable disease and infections." The P&P indicated, "The IPCP includes the following: Reviewing, establishing and monitoring environmental infection control approaches in accordance with CDC/HIPAC/OSHA guidelines and local or state requirements to provide the community with a safe and sanitary environment. The P&P further indicated, "The IPCP includes the following: Providing guidance for maintaining the community in a sanitary fashion: Reviewing food handling practices, laundry practices, pest control, traffic control, visiting rules for high-risk areas and sources of airborne infection." A review of the U.S. Food & Drug Administration Food Code, dated 2017, the food code indicated under 6-501.111 Controlling Pests, "Insects and other pests are capable of transmitting disease to humans by contaminating food and food-contact surfaces. Effective measures must be taken to eliminate their presence in food establishments." The facility failed to have an effective pest control program, to prevent cockroaches in the kitchen for a facility licensed for a 59-bed count. As a result, live roaches were found in the facility’s kitchen. This deficient practice had the potential to expose 38 residents currently residing in the facility to foodborne illness. These violations, jointly, separately, or in any combination, had a direct or immediate relationship to the health, safety, or security of patients or residents.